There are so many exciting decisions when you're getting married. You get to plan the perfect wedding, pick the perfect dress (or tux!), escape on the perfect honeymoon and select the perfect... health insurance? Okay, you got me. Health insurance is not the most exciting decision. Yet choosing what health insurance changes - if any- you should make is very important. Do you join your spouse's employer-sponsored coverage? Do you add them to your plan? Should you look for a plan on the individual Health Insurance Marketplace? Although my husband and I didn't tie the knot until this past November, we were exploring our health insurance decisions long before the official date. After all, your health insurance has a lot of significant impacts. What doctors can you see? Which hospitals can you go to? What type of health services can you get? What will it cost you? At the end of our decision-making process, we decided to add my husband to my employer-sponsored coverage. If you're not sure where to start, here's a checklist of things we considered:
Choice of doctors and hospitals included in the plan
It was important for my husband to keep his primary care doctor. Not all doctors accept all insurance plans so we used this find a doctor tool to make sure his primary doctor was covered under the Blue Cross plan we chose.
The type of network
There are two predominant types of health insurance plans: PPOs and HMOs.
- HMO (Health Maintenance Organization): An HMO requires that you select a primary doctor who is responsible for managing and coordinating all of your health care. While HMOs typically cost a bit less, you must get a referral from your primary doctor if you need care from a specialist or a diagnostic service such as a lab test or x-ray. If you do not have a referral or you choose to go to a doctor outside of your HMO’s network, you will most likely have to pay all of, or most of, the cost for the care.
- PPO (Preferred Provider Organization): If you have a PPO, you may choose to receive covered services from an in-network or out-of-network doctor, but you will pay less if you choose in-network. You do not need a referral or authorization from your primary doctor or insurer to see a specialist.
Coverage for maternity services and dependents
If you are planning on starting a family, it's important to consider what coverage is available for pre-and-post-natal care, giving birth, immunizations and child health care.
Total cost - not just monthly payment
We are saving up for our future and our budget is very important to us. The cost of health insurance isn't as simple as comparing what you pay each month to have the plan. There are five costs that make up a health plan, and you have to consider each of them when deciding which option is the most cost-effective for you. My husband and I both have monthly prescriptions, so it was important to include that in the cost. Every family is different in their needs and priorities when it comes to health insurance. Understanding your options is the best approach before deciding on whose plan to join. Looking for more information on how to get the right care? You may also like these blogs:
Photo credit: Abby Boyd